This proposal investigates the role of the primary care to disaster victims, and area of surprising neglect both in develop and developing countries. It draws from the experience following the disasters in columbia (1985) and Ecuador (1987). Its specific aims are to: (i) ascertain the prevalance of mental distress and psychiatric disorders among the disaster victims; (ii) assess the PCWs' ability to detect patients with emotional problems; (iii) evaluate the efficacy of a focused training course in disaster mental health on the PCWs' detection skills; and (iv) probe into long-term consequences of disasters and alternative management strategies. Associated aims related to disaster psychopathology include: (i) comparing emotional symptoms of victims of disasters with different magnitudes; and (i) comparing emotional symptoms of victims of disasters with different magnitudes; and (ii) probing into the relative contributions of individual vulnerabilities, social situation aNd stressors. In a collaborative effort with local research teams, data were collected on 450 victims, and on PCWs' detection skills. The design involved a two-stage evaluation: (i) screening a sample of subjects with the Self-Reporting Questionnaire to ascertain levels of non-specific distress; and (ii) psychiatric examination of a subsample to produce DSM-III diagnoses. In primary care clinics, PCWs were also asked if the patient had an emotional disorder. The PCWs' clinical impression was compared with the research diagnosis to ascertain the PCWs' accuracy in detecting emotional problems. For Ecuador, an intervention was carried out as well. A training course on disaster mental health was given to PCWs, and their detection skills were assessed before and after the course. This project will also collect new data on the Colombian victims. The original study subjects will be re-examined with additional questions on relevant intervening life-events. We will also obtain data on physical and mental health status, and on utilization of general/mental health services and community resources. These data will provide initial information on issues of management, which will be the focus of subsequent research.